The Health Information Management Study evolved as the result of a recognition on the part of member physicians of the Physicians Association of Clackamas County that communications problems between physicians in a dispersed HMO are significant. With this recognition came the realization that computerized communication and information systems could potentially alleviate this problem. The HIMS Project intends to examine the feasibility and cost-effectiveness of computerization and/or improved manual systems to accomplish the goal of improved communications. Some examples of systems to be studied are medical records systems, consultation and referral systems, and scheduling systems. The study is to be conducted in such a way that whatever systems modifications are eventually implemented, the data will be available to compare, in a comprehensive manner, the revised system with the system it replaces.